This article was written for the Canadian Cat Association
Newsletter Sept 2013.

This article may not be reproduced without
permission.

When I started breeding and showing cats in 2003
– Very few breeders had heard of a
heart disease called Hypertrophic Cardiomyopathy (HCM).Even
fewer scanned their cats for this disease.As
I was going to be a Sphynx breeder, I spent a lot of time learning about
potential health issues in Sphynx.A
few Sphynx owners had told me their Sphynx had died young of heart issues -
usually of HCM. I wanted to try my best to mitigate any health issues in my
program so I researched HCM thoroughly.

Hypertrophic Cardiomyopathy (HCM) is found in all cat breeds and is the most
common heart disease found in all domestic cats.HCM
is a thickening of the heart'sleft
ventricle wall.This
is generally a genetic disease, but there can be secondary causes such as
thyroid issues. Some cats
that have heart conditions show no outward symptoms (ie heart murmur) when
checked by a non-specialist vet.

It is often known as the silent
killer as some cats have no symptoms until they in cardiac arrest.

After my research, I knew I needed to do regular echocardiograms on all my
breeding cats. And… most importantly – these exams had to be done by a board
certified cardiologist.

MY FIRST EXPERIENCE SCANNING:On
Saturday, June 19, 2004, I drove two hours with my first breeding female “Aviah”
to get her heart scanned at Chesapeake Veterinary Cardiology Associates (CVCA)
in Towson Maryland.I
was as nervous as could be and really had no idea what to expect. The scan
process itself was easy – first, the cardiologist completed a physical examination,
listened to the heart. After that, we were taken into a darker room where
the cat is laid on its side on a table with a hole in it. Then the ultrasound
probe is put up to the chest. The echo itself
was about a 4-5 minute procedure.Fortunately
– my cat Aviah at 1 year old, did have a normal scan.The cardiologists were so
nice and willing to answer any questions.

It was quite an experience! I hardly slept the night before due to
nervousness… and then feeling of relief after the fact… and then knowing it will
happen again in about a year. I was very new to the process of HCM scans and
had a lot to learn. I was unaware that heart scans have interpretation involved.
Not all scans are black and white. Sometimes they can have something trivial
wrong with it but the heart is still considered "normal" by a cardiologist.
Another thing I was shocked about was that many cats have stress murmurs at the
vets!

Over the years, I continued to scan my breeding cats at CVCA in Towson.
There
was a lull in the CVCA-Towson HCM clinics for awhile, so I waited… and waited.No
one was stepping up to the plate, so I decided I would ask if I could set a
clinic up because I needed cats scanned! CVCA said yes and gave me a date to set
up times.The set-up
entails taking all the cats’ information and setting up times prior to the
clinic so all the information can be entered into the CVCA system.For
almost 6 years now, I have been setting up HCM clinics in the Maryland area. It
does take time & is volunteer work, but it is rewarding to know these clinics
help better each of the dedicated breeder’s program.There
are about 35-40 cats that get scanned at these quarterly discounted weekend
clinics.It is not just
Sphynx that go to these HCM clinics… but Bengals, American Shorthairs, Ragdolls,
Turkish Angoras, Persians, Cornish Rex, Devon Rex, Maine Coons.HCM
is not just a Sphynx disease as some purport it to be.

Steven L. Rosenthal DVM Diplomate ACVIM Cardiology states:

"The ideal time to diagnose and start to manage cats with hypertrophic
cardiomyopathy and other feline heart diseases is at a time that symptoms are
not present. There are a number of ways to screen cats for heart disease
with the current gold standard being via echocardiography. In the mid
1990's the doctors of CVCA starting screening breeding cats for HCM and we
diagnosed almost one third of the cats with HCM. We have seen those
percentages reduced through active screening of breeding cats and their
relatives. Currently we find a much lower percentage of affected cats and
when cardiomyopathy is found it can often be managed medically for many years
with the goal of improving the quality and quantity of the lives of these
affected cats. "

Scanning does help breeding programs immensely. I am and always will be an
advocate for regular HCM scanning.Pet
buyers and breeders alike should seek to support breeders that scan regularly
and are open about their results. If you are going to purchase a kitten as a
breeder or as a pet, do not be afraid to ask for the HCM scan of the parents.

Some will argue that the cat’s “normal” scan is only good for today. And they
are not wrong except they leave out one very important part!If
the cat has a genetic heart issue, removing that cat from a breeding program is
so important.

These are my personal examples of how scanning & pedigree study
has helped my breeding program.

1

NOT
HCM??:
Kayla - so healthy, not ever a cold and very active. When I took her to be scanned she was diagnosed by
the cardiologists "NOT FOR BREEDING" because she has mitral & tricuspid
valve dysplasia. The cardiologists told me that her offspring could have it
worse than Kayla and require medications. If I had not taken her to the
cardiologist, I would have never known and might have bred these issues. Kayla
does not have HCM, but it is still thought to be a genetic heart defect.

HCM POSITIVE:My
breeding partner and I purchased a male cat named Earl. At 13 months old, Earl
appeared to be in excellent health and we were shocked to learn that he was HCM
positive. Thankfully, he was never used in a breeding program to perpetuate this
problem. Sadly, in July 2012, at just 3.5 years old, he passed away in a loving
pet home.

MEDICAL BENEFITS FOR HCM POSITIVE CATS:In
Spring 2013, my breeding partner contacted me with news that makes your heart
sink. She let me know several cats she had bred and placed as pets had heart murmurs. These kittens were all out an
outside stud male from Georgia.
As far as we knew, that male was only scanned by his breeder one time.The
one and only kitten I had from this stud cat, Carlito, was altered, petted out and not used in my breeding
program. He was now 4 years old. I immediately contacted his owners and let them
know the news. They are truly great pet owners and took Carlito to the board
certified cardiologist at CVCA to get scanned within 2 weeks.

When the day came - the news
was not good - Carlito was HCM positive. It was not mild either, but
moderate. Carlito was put on appropriate medications and needed a recheck in 6 months. The recheck
would be very telling if the medicine was able to help Carlito.

The
medicine can help but it does not work in all cases.

On Sept 16, 2013, Carlito went in for his 6 month recheck and the owners got
excellent news. His heart function had improved and so the medicine was working
so there was a very good prognosis! It was amazing news.

(The
other two cats that had murmurs, Smokey & Bandit, were also HCM positive,
theirs was more mild.)

Update: June 12, 2015 Carlito visited CVCA and
his heart issues have continue to stabilize with medication and he continues to
do well.

HCM is very scary diagnosis, however, proper medical treatment can improve the
cat’s heart function and thereby increase its lifespan.

IMPORTANCE OF PEDIGREE: Another Sphynx I had, Claire, was
already altered and not used in a breeding program because of a very risky pedigree. She was my forever pet and
I wanted to scan her to ensure she did not need medicine. Much to my surprise -
her scan was normal. Six months later on a beautiful
Saturday afternoon on Sept 15, 2008, Claire
appeared to be sleeping on the bedroom chair. I went over to touch her and she was cold.
I touched her again in shock and disbelief. I screamed. And screamed. I could not
believe Claire was gone.I
was in hysterics and almost did not get a necropsy done. I realized I had
to know even though I did not have her lines
any longer. When the necropsy report came back, she had a cardiac
arrhythmia and her heart was 1.5 times larger than it should have been for a cat
her size.

This is an extremely important example to show how breeders must pay attention
to the pedigree as well as scan. Scanning is only one tool. The pedigree is
another.Some may have
ignored this pedigree risk and bred Claire with a clear scan.

Everyone is going to have a different risk threshold and each individual needs
to evaluate that carefully.

WHAT IS IN THE HEART: Motives
for scanning do matter. If one scans to market their cats for sales, there is
the possibility that only the good will be reported.Timeliness
of the information is important as well.Sometimes
people do not tell you about the scans or share the appropriate documents. Make
sure you see the actual documents for the scans or ask if you can speak with the
cardiologist to confirm the information. There are databases out there. Unless
it is run by an unbiased, non-breeder, do not trust it. I am not sure about
other breeds, however I know in the Sphynx databases, there are definitely
mistakes. Some cats are positive and marked not so.

HCM POSITIVE CATS IN A LINE MAKE A BREEDER BAD?HCM
positive cats alone do not make a breeder “bad” or one to avoid.Even
proactive breeders will have HCM pop up as scanning is only a tool. Ragdolls and
Maine Coons have the DNA testing however the DNA testing is not a perfect tool
either as there are thought to be many HCM mutations.

As with most things, it is the actions taken that differentiate a conscientious
breeder from the rest. When this does happen, a caring breeder needs to assess
the risk and takes action to mitigate the risk. These actions include
informing those with related lines immediately and possibly altering related
cats and/or using them with more caution.

A good breeder wants to know how pets in pet homes are
doing. Truthfully, this is the best gauge of how a breeding program is going.

BOTH MY CAT'S PARENTS ARE TESTED NORMAL, HOW
CAN MY CAT HAVE HCM?
Unfortunately, the HCM scanning and pedigree study is not a perfect tool. You
can get an HCM positive cat out of two negative parents. The transmission is
thought to be autosomal dominant with variable expression. The variable
expression is how this disease gets tricky. This means a parent can have the
gene but never express it in its lifetime or express it much later on. But this
gene can be passed along to an offspring and the offspring can develop HCM.
This variability makes it harder to detect.

CONCLUSION:

HCM scanning is something that is really
beneficial to all breeds. It is not a perfect tool, but it does help the
breeders, the pet buyers and the cat's themselves.
As time as gone on, more and more breeders of all breeds realize this and
now scan
for HCM.

I hope my very personal
experiences show how important it is to take breeding cats to the cardiologist
and demonstrates that breeders cannot rely on the scan alone. Responsible
breeders must remain cautious in breeding programs and consider the pedigree as
well. Those who scan, share the information about their lines with those they
work closely with, and are cautious literally help avoid a lot of heartache.